Aging related cognitive changes associated with Alzheimer's disease in Down syndrome
| Autor: | Daniel Alexander, Andre Strydom, Elizabeth Fisher, Carla Startin, Sarah Hamburg, Peter Wijeratne, Rosalyn Hithersay, John Hardy, Kin Ying Mok, Nicholas Firth |
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| Rok vydání: | 2018 |
| Předmět: |
0301 basic medicine
Down syndrome business.industry General Neuroscience Disease medicine.disease Cognitive test Motor coordination 03 medical and health sciences 030104 developmental biology 0302 clinical medicine Medicine Verbal fluency test Dementia Neurology (clinical) Cognitive skill Cognitive decline business 030217 neurology & neurosurgery Clinical psychology |
| Zdroj: | Annals of clinical and translational neurology. 5(6) |
| ISSN: | 2328-9503 |
| Popis: | Objective Individuals with Down syndrome (DS) have an extremely high genetic risk for Alzheimer's disease (AD), however, the course of cognitive decline associated with progression to dementia is ill-defined. Data-driven methods can estimate long-term trends from cross-sectional data while adjusting for variability in baseline ability, which complicates dementia assessment in those with DS. Methods We applied an event-based model to cognitive test data and informant-rated questionnaire data from 283 adults with DS (the largest study of cognitive functioning in DS to date) to estimate the sequence of cognitive decline and individuals' disease stage. Results Decline in tests of memory, sustained attention/motor coordination, and verbal fluency occurred early, demonstrating that AD in DS follows a similar pattern of change to other forms of AD. Later decline was found for informant measures. Using the resulting staging model, we showed that adults with a clinical diagnosis of dementia and those with APOE 3:4 or 4:4 genotype were significantly more likely to be staged later, suggesting that the model is valid. Interpretation Our results identify tests of memory and sustained attention may be particularly useful measures to track decline in the preclinical/prodromal stages of AD in DS whereas informant-measures may be useful in later stages (i.e. during conversion into dementia, or postdiagnosis). These results have implications for the selection of outcome measures of treatment trials to delay or prevent cognitive decline due to AD in DS. As clinical diagnoses are generally made late into AD progression, early assessment is essential. |
| Databáze: | OpenAIRE |
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